Schaeffer Doris, Griese Lennert, Berens Eva-Maria
Fakultät für Gesundheitswissenschaften, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Universität Bielefeld, Bielefeld.
Gesundheitswesen. 2020 Nov;82(11):836-843. doi: 10.1055/a-1276-0418. Epub 2020 Nov 13.
People with chronic illnesses (Pwci) face a variety of challenges in managing their illness and using health care. Thus, their need for information and health literacy (HL) is high. While the topic has already been addressed in international research, there is a lack of studies on health literacy among Pwci in Germany.
The aim was to analyze HL among Pwci in Germany in more detail. For this purpose, cross-sectional data from a total of 499 Pwci of the German Health Literacy Survey (HLS-GER) were used. HL was assessed with the European Health Literacy Survey Questionnaire (HLS-EU-Q 47). Possible differences in the distribution of low HL by socio-demographic characteristics (gender, age, social status, financial resources, educational level and functional HL (assessed with the Newest Vital Sign (NVS)) and disease-related characteristics (number of diseases and disease duration) were tested using chi-square tests. To investigate the influence of these factors on low HL among Pwci, a multiple logistic regression was performed.
Low HL was found in 72.7% of Pwci. Low HL differed greatly according the single domains healthcare, prevention and health promotion. Low social status (OR: 4.4 [1.8; 10.7]), low financial resources (OR: 2.0 [1.2; 3.1]), limited literacy skills (OR: 2.7 [1.4; 5.0]), and an intermediate-level of education (OR: 0.5 [0.3; 0.9]) were associated with low HL in multiple logistic regression. Number and duration of chronic illnesses were not significantly associated with low HL.
The analysis provides initial findings for Germany that need further investigation. However, they already provide important indications for intervention development. It is necessary to develop target group-specific interventions for strengthening personal health literacy of Pwci, specifically addressing people with low social status, low financial resources and limited literacy. To avoid stigmatization, it is also important to address the information demands in the personal environment. Interventions should make it easier to search for, acquire and process information and thus contribute to reducing inequality.
慢性病患者在管理自身疾病和使用医疗保健服务方面面临各种挑战。因此，他们对信息和健康素养的需求很高。虽然该主题在国际研究中已经有所涉及，但德国慢性病患者的健康素养研究却很匮乏。
旨在更详细地分析德国慢性病患者的健康素养。为此，使用了来自德国健康素养调查（HLS-GER）的499名慢性病患者的横断面数据。健康素养通过欧洲健康素养调查问卷（HLS-EU-Q 47）进行评估。使用卡方检验来检验低健康素养在社会人口学特征（性别、年龄、社会地位、经济资源、教育水平和功能性健康素养（通过最新生命体征（NVS）评估））以及疾病相关特征（疾病数量和病程）方面分布的可能差异。为了研究这些因素对慢性病患者低健康素养的影响，进行了多元逻辑回归分析。
72.7%的慢性病患者健康素养较低。在医疗保健、预防和健康促进等单个领域，低健康素养存在很大差异。在多元逻辑回归分析中，低社会地位（比值比：4.4 [1.8；10.7]）、低经济资源（比值比：2.0 [1.2；3.1]）、有限的读写能力（比值比：2.7 [1.4；5.0]）以及中等教育水平（比值比：0.5 [0.3；0.9]）与低健康素养相关。慢性病的数量和病程与低健康素养无显著关联。
该分析为德国提供了初步研究结果，尚需进一步调查。然而，这些结果已经为干预措施的制定提供了重要指示。有必要针对特定目标群体制定干预措施，以增强慢性病患者的个人健康素养，特别是针对社会地位低、经济资源少和读写能力有限的人群。为避免污名化，关注个人环境中的信息需求也很重要。干预措施应使信息的搜索、获取和处理更加便捷，从而有助于减少不平等现象。
